Complementary medicine: what Swiss health insurance pays

The decisive question: who is treating you?

Compulsory basic insurance (OKP) only covers complementary medicine treatment under two conditions: it must be one of the recognised methods — these include acupuncture, anthroposophic medicine, homeopathy, phytotherapy (herbal medicine) and Traditional Chinese Medicine (TCM), among others — and it must be carried out by a suitably qualified doctor.

Complementary treatment by non-medical therapists — such as naturopathy or osteopathy — is not covered by basic insurance: what matters is not only the method but also who carries it out. Only supplementary insurance for complementary medicine steps in here.

Treatment by a doctor: the rules of basic insurance

If basic insurance pays, the usual cost sharing applies: first you pay your deductible (adults CHF 300 to 2'500, children CHF 0 to 600), then a 10% co-payment up to a maximum of CHF 700 per year (children CHF 350).

Two points are often overlooked: if you have a cost-saving model (family doctor, HMO or telemedicine), you must in principle follow the prescribed treatment pathway here too — otherwise you risk a reduction in benefits. And for outpatient treatment, you usually pay the invoice yourself first and submit it to your insurer (“tiers garant”). Also submit invoices below the deductible — this is the only way your deductible balance is recorded correctly.

How supplementary insurance for complementary medicine works

At many insurers, complementary medicine is a separate area of supplementary insurance — alongside outpatient supplements, hospital and dental insurance. These products are governed by the Insurance Contract Act (VVG): they are voluntary and subject to private law.

The benefit is usually structured as a percentage: the insurer contributes a certain percentage of the treatment costs, up to an annual limit. The list of therapists is also decisive: as a rule, only treatment by recognised therapists is reimbursed — recognition via EMR registration, for example, is widespread. Which methods and registers the specific product recognises and whether waiting periods apply is set out in the AVB.

Practical tip: before your first appointment, check whether the therapist and method are recognised by your insurer and how much of your annual limit is left — that way you avoid uncovered invoices.

Health check: the insurer may reject you

Unlike basic insurance, supplementary insurance has no obligation to accept: the insurer decides on the basis of a health declaration and may impose reservations or reject the application. Answer the health questions truthfully — false information can put the contract at risk.

Two practical rules follow from this: take out the supplement while no specific need for treatment is foreseeable, if possible. And for children: if you register them before birth, there is no health check at all. Finally, when switching, the golden rule applies: only cancel your existing supplementary insurance once you have the new insurer's written acceptance confirmation.

Is a complementary medicine supplement worth it?

Be honest with your sums: set the benefits you actually use against the annual premium. If you regularly use non-medical therapies, you often recoup the premium through the percentage contributions; if you only use treatment occasionally, you should check critically whether the supplement pays off.

Compare the benefits first and only then the price: two products with similar premiums can have quite different limits and lists of therapists. In the easyall comparison you can filter supplementary insurance by category, and easy, our AI guide, can look up details directly in the insurance conditions of the product concerned.

Deadlines for taking out cover and switching

In principle, you can take out new cover at any time — the insurer decides on acceptance and the start date after the health check. When switching existing supplementary insurance, however, these dates count:

• Check the minimum term: many products tie you in for 3 years, some for 1 year. Statutory upper limit (revVVG Art. 35a): every supplementary health insurance can be cancelled at the latest as of the end of the 3rd insurance year and annually thereafter — with 3 months' notice, in text form.
• Cancellation date: at most insurers, supplementary insurance ends on 31 December; the cancellation must reach your current insurer by 30 September — what counts is receipt, not the postmark.
• Allow for lead time: submit the application, wait for the acceptance confirmation, let the 14-day revocation period expire — so ideally submit the application by mid-August.
• Ideal start for the new policy: 1 January. If it starts earlier, you will temporarily pay two supplementary premiums in parallel.
• If you take out cover via easyall, the cancellation letter is created automatically; you compare benefits and premiums in the calculator.